Ebo D G, Stevens W J
Department of Immunology, Allergology and Rheumatology, University of Antwerp, Universiteitsplein 1, B 2610 Antwerpen.
Acta Clin Belg. 2002 Mar-Apr;57(2):58-70. doi: 10.1179/acb.2002.015.
In the past 2 decades, IgE-mediated NRL allergy has become a well-defined condition with recognised risk groups, established diagnostic tools, and adequate prevention strategies (1-3). Furthermore, molecular biology and biochemical techniques have significantly improved our knowledge of the proteins responsible to cause the disease. Clinical manifestations will not be addressed in this review, nor will broad preventive strategies be proposed; these have been discussed elsewhere (4, 5). After a brief introduction this review will focus on specific issues: (1) How do we estimate the prevalence of NRL allergy and who is at risk for clinical sensitisation? (2) What specific allergens cause NRL allergy? How does sensitisation for these allergens occur? Are all patients sensitised for the same allergens? Threshold allergen exposure levels. (4) What is the latex-fruit syndrome? What is the clinical relevance of a positive plant food specific IgE quantification in patients with NRL allergy? (5) How do we diagnose NRL allergy? What are the strengths and weaknesses of currently available diagnostic tools? (7) How do we manage NRL allergy? What is the role of medication and immunotherapy in the treatment of NRL allergy? How do we select an appropriate non-NRL alternative for NRL gloves? Which regulatory provisions have been implemented?
在过去20年里，IgE介导的天然橡胶乳胶过敏已成为一种定义明确的病症，有公认的风险群体、既定的诊断工具和适当的预防策略（1-3）。此外，分子生物学和生化技术显著增进了我们对引发该疾病的蛋白质的了解。本综述将不涉及临床表现，也不会提出广泛的预防策略；这些内容已在其他地方讨论过（4, 5）。在简要介绍之后，本综述将聚焦于特定问题：（1）我们如何估计天然橡胶乳胶过敏的患病率，哪些人有临床致敏风险？（2）哪些特定过敏原会导致天然橡胶乳胶过敏？这些过敏原的致敏是如何发生的？所有患者对相同的过敏原都致敏吗？过敏原暴露阈值水平。（4）乳胶-水果综合征是什么？在天然橡胶乳胶过敏患者中，植物性食物特异性IgE定量呈阳性的临床意义是什么？（5）我们如何诊断天然橡胶乳胶过敏？现有诊断工具的优缺点是什么？（7）我们如何管理天然橡胶乳胶过敏？药物治疗和免疫疗法在天然橡胶乳胶过敏治疗中的作用是什么？我们如何选择合适的非天然橡胶乳胶替代品用于天然橡胶乳胶手套？已实施了哪些监管规定？
